HomeMy WebLinkAboutGeorgetown Mobility Coalition - Campaign Finance ReportSPECIFIC -PURPOSE COMMITTEE
FORM SPAC
CAMPAIGN
FINANCE REPORT
COVER SHEET PG 1
1 Filer ID (Ethics Commission Filers)
2 Total pages filed:
The SPAC Instruction Guide explains how to complete this form.
8
3
COMMITTEE NAME
USE ONLY
MI/^,OFFICE
".n
� ■ IQ4�..;It+ ` C5AIf+;0r7
Date Received
f V fir`;
RECEIVED
Q
COMMITTEE
ADDRESS / PO BOX; APT /SUITE #; CITY; STATE; ZIP CODE
ADDRESS
3C:;-' I �; Il,•4 �'S ^r'v`
APR 0 8 2021
Change of Address
�'�`''�� -Ty za
MGMT, SVCS.
Date Hand -delivered or Date Postmarked
5
CAMPAIGN
MS / MRS / MR FIRST MI
TREASURER
J
Receipt # Amount $
NAME
a 1 rw— Sr
...............................................................................
NICKNAME LAST SUFFIX
Date Processed
pQ//��
Cr) Gr`r
Date Imaged
6
CAMPAIGN
TREASURER
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY; STATE;
ZIP CODE
STREETADDRESS
_
(Residence or Business)
ae-01111-3&PW , v
7
CAMPAIGN
TREASURER
STREET ADDRESS OR PO SOX; APT 1 SUITE h; CITY; STATE;
�Q + l� S
ZIP CODE
MAILING ADDRESS
ar 1 VQ,
�^ y
Change of Address
� �E 4 10 W yj
8
CAMPAIGN
AREA CODE PHONE NUMBER EXTENSION
TREASURER
PHONE
p,
January 15 30th day before election
Exceeded Modified Reporting Limit
9 REPORTTYPE
❑���111 8th day before election
July 15
Dissolution Report (Attached PAC-FR)
Runoff
10th day after campaign treasurer termination
10 PERIOD
COVERED
Month Day Year
Month Day Year
2— /'0 /.. -z r THROUGH
!
3 ZZ/ Z ,
11
ELECTION
ELECTION DATE
ELECTION TYPE
Month Day Year
D Primary ❑ Runoff Other
L I
J
`x General M Special
Description
GO TO PAGE 2
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11 /13/2020
SPECIFIC -PURPOSE COMMITTEE REPORT: FORM SPAC
PURPOSE AND TOTALS COVER SHEET PG 2
12 COMMITTEE NAME ID (Ethics Commission Filers)
T13_71er
*aW _
14 COMMITTSJ CANDIDATE/OFFICEHOLDER NAME
PURPOSE CANDIDATE
(Attach lists on plain paper to
complete this report if OFFICE SOUGHT (candidate) /OFFICE HELD (officeholder)
necessary.)
OFFICEHOLDER
SUPPORT
+���-��� (Candidate or Measure) BALLOT IDENTIFICATION/# ELECTION DATE
Month Day Year
OPPOSE
f
(Candidate or Measure) MEASURE
DESCRIPTION
ASSIST
(Officeholder) Q 1 1
15 CONTRIBUTION
1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (O ER THAN
TOTALS
PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR
$
CONTRIBUTIONS MADE ELECTRONICALLY)
Check here if this report qualifies for the higher itemization threshold
2. TOTAL POLITICAL CONTRIBUTIONS
$
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
............................
EXPENDITURE
3. TOTAL UNITEMIZED POLITICAL EXPENDITURES
O
TOTALS
4. TOTAL POLITICAL EXPENDITURES
$ �i ��.• ��
............................
CONTRIBUTION
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY
../
$ Z�Z
BALANCE
OF THE REPORTING PERIOD
T / •�D
............................
OUTSTANDING
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANSAS OF THE
$ O
LOAN TOTALS
LAST DAY OF THE REPORTING PERIOD
16 SIGNATURE I swear, or affirm, under penalty of perjury, that the accompanying report is true and correct and
includes all information required to b rted by me and r 5, E ion Code.
F
' + ASHME 10(, MOUSES m Signature of Campaign Treasurer (Declarant)
MY NOWY ID # 1M1024
•'�. „ F-plr pecernbarZ 2022 Please complete either option below:
(1) A#fida�lt:
AFFIX NOTARY STAMP / SEALABOVE
Sworn to and subscribed before me, by the said, V C�� CAAX U L this the
d of 0 , 20 —2-1- to certify which, witness my hand and seal of office.
LKLE ll
Signature of officer administering oath Printed name of officer administering oath Itfe of officer administering oath
(2) Unsworn Declaration
My name is and my date of birth is
My address is _
'
(street) (city) (state) (zip codeXcountry)
Executed in County, State of on the day of .20
(month) (year)
Signature of Campaign Treasurer (Declarant)
Forms provided by Texas Ethics Commission uwwu.ethics.state.tx.us Revised 11/13/2020
SUBTOTALS - SPAC
FORM SPAC
COVER SHEET PG 3
17 C0MMI'17EE N ME 18 Filer ID (Ethics Commission Filers)
WN ` �►a�111� vC>�l;�;al�
19
SCHEDULE SUBTOTALS
SUBTOTAL
NAME
OF SCHEDULE
AMOUNT
1
SCHEDULE Al: MONETARY POLITICAL CONTRIBUTIONS
$
2.
SCHEDULE A2 : NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS
$
O
$
3. SCHEDULE B: PLEDGED CONTRIBUTIONS
4•
SCHEDULE Cl: MONETARY CONTRIBUTIONS FROM CORPORATION OR LABOR ORGANIZATION
$
O
5
❑
SCHEDULE C2 : NON -MONETARY (IN -KIND) CONTRIBUTIONS FROM CORPORATION OR LABOR
ORGANIZATION
$
6•
❑
SCHEDULE D: PLEDGED CONTRIBUTIONS FROM CORPORATON OR LABOR ORGANIZATION
$
V
7.
❑
SCHEDULE E: LOANS
$
C)
8.
SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$�
9.
SCHEDULE F2: UNPAID INCURRED OBLIGATIONS
$
10.
E
SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS
$
11.
I —I
SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD
$
12.
H
SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH
$
0
$
O
13.
El
SCHEDULE I: NON -POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS
$
O
14 ❑ SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED
TO FILER
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/13/2020
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
1 Total pages Schedule At ' Q�
2 FILER !NAME
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3 Filer ID (Ethics Commission Filers)
4 Date
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7 Amount/off contribution
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6 Contributor address; City; St te; Zip Code
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8 Principal occupation / Job title (See Instructions)
g Employer (See Instructions)
Date
Full name of contributor ❑ oul--of-slate PAC (ID#: )
Amount of contribution ($)
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Contributoorj addre s; City; late; Zip Code
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Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor ❑ out-of-state PAC (ID#:` —)
Amount of contribution ($)
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Contributdress. City; State; Zip Code
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Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Full name of contributor ❑ out-of-state PAC (ID#: ) Amount of contribution ($)
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Principal occupation / Job title (See Instructions) 7E(See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see Instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics state tx.us Revised 11/13/2020
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
I Total page Schedule Al
Z D* —a;
2 riL�NAME � I. � / �
3 Filer ID (Ethics Commission Filers)
4 Date
5 Full name of contributor ❑ out-of-state PAC (ID#: )
7 Amount of contribution ($)
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6 Contributor address; City; State; Zip Code
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8 Principal occupation / Job title (See Instructions)
g Employer (See Instructions)
Date Full name of contributor ❑ out -of -stale PAC (ID#: ) Amount of contribution ($)
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Contributor ddress; city; State; Zip Code �• ��
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Principal occupation / Job title (See Instructions) Employer (See Instructions)
Date
Full name of contributor ❑ out-of-state PAC (IDAt:_
Amount of contribution ($)
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Contributor City; Zip Code
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Principal occupation / Job title (See Instructions)
Employer (See Instructions)
Date
Full name of contributor ❑ out-of-state PAC (ID#: )
Amount of contribution ($)
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Contributor dd CIty; State; Zip Code
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Principal occupation / Job title (See Instructions)
Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see Instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www ethics.state tx.us Revised 11/13/2020
MONETARY POLITICAL CONTRIBUTIONS SCHEDULE Al
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
7 Total page Schedule Al:
3 oar 3
2 FILER NAME
Gcocq &bum Mob; I;+
3 Filer ID (Ethics Commission Filers)
4 Dat, 5 Full name of contri utor ❑ out-of-state PAC (ID#: )
7 Amount of contribution ($)
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6 Contributor address; ity; State; Zip Code
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8 Principal occupation / Job title (See Instructions)
g Employer (See Instructions)
Date
Full name of contributor ❑ out -of -stale PAC (ID#: )
Amount of contribution ($)
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Contributor "dress; Cit sthte; Zip Code
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Principal occupation / Jo le (See Instructions)
Employer (See Instructions)
Date
Full name of contributor ❑ out -of -slate PAC (ID#: )
Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions) Employer (See Instructions)
Date
Full name of contributor ❑ out-of-state PAC (ID#: )
Amount of contribution ($)
Contributor address; City; State; Zip Code
Principal occupation / Job title (See Instructions)
Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULEAS NEEDED
If contributor is out-of-state PAC, please see Instruction guide for additional reporting requirements.
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/13/2020
POLITICAL EXPENDITURES MADE FROM POLITICAL
CONTRIBUTIONS SCHEDULE F1
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services SalariesANages/Contract Labor Other (enter a category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
'1 Total Rag s Schedule F1:
2 FILER NA E p
lta�'
3 Filer ID (Ethics Commission Filers)
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4 Date 5 Payee lr`a. } e
z A (a_7Dcery
6 Amount ($) 7 Payee addre s; City; State; Zip Code
417 cj"ewoss GevZeew» )( 7re&Z46
8 (a) Category (See Categories listed at the top of this schedule) (b) Description
PURPOSE 4A'je_A;'0;4 �x�¢�t�G Sun ei�-y S��n 60grj rlelnl'
EXPENDITURE
(c) Check it travel outside of Texas. Complete Schedule I� Check if Austin. TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Payee address, City; State; Zip Code
Amount ($)
41,
Z texas Sri ve, Gcor5efo , /�x �$lozg
Category this schedule)
(S(See Categories listed att the top
J
PUROPOSE
uof eDescription t
u ����
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EXPENDITURE
Check if travel outside of Texas Complete Schedule ❑ Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
7'
Payee name`
res S
Payee address; City; State; Zip Code
IQo4 S. -'N l-ve.• Gem ��awn JX 786Z42
Amount ($)
z,0/7-
Category (See Categories listed at the top of this schedule) Description
PUROPOSE
EXPENDITURE
�Q.�GV 1 i N x�Q11�e, -asp h ?r I N+ 1 "V
Gam/ 1
Check iftravel outside ofTexas,Complete ScheduleT. ❑ Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/13/2020
POLITICAL EXPENDITURES MADE FROM POLITICAL
CONTRIBUTIONS SCHEDULE F1
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement Solicitation/Fundraising Expense
Accounting/Banking Fees Office Overhead/Rental Expense Transportation Equipment & Related Expense
Consulting Expense Food/Beverage Expense Polling Expense Travel In District
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense Travel Out Of District
Candidate/Officeholder/Political Committee Legal Services Salades/Wages/Contract Labor Other (entera category not listed above)
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total paagg@s Schedule F1: 2 I�R� NAM 3 Filer ID (Ethics Commission Filers)
/t 10�/
TL ``/)
r7
4 Date
3 - g -z 1
6 Payee na L
Orat^ CS CarTer
_
6 Amount ($)
_
7 Payee address; City: State; Zip Code
F 1, 7cx� -e=O
z3q- 0Ide C Ic 7r;ve own TX -v&&3
8
(a) Category(See Categories listed at the top of this schedule) (b) Description
PURPOSE
EXPENDITURE
A'ejVeXTfsf V fXfCYJ4t '57,, V1 ,VV40 (IA/ I i 0�
(c) Check if travel outside of Texas. Complete Schedule Check if Austin, TX, officeholder living expense
9 Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name p
� e.� �u>y1 u iT Tm 4c-
�,Nl
Amount ($)
Payee address; City; � State, Zip Code
ct
FZ IWIR►r, 1/I�rIIe 1 v Sax 3
.
Category (See Categories listed at the top of this schedule)
Description
PURPOSE
OF
EXPENDITURE
Check if travel outside of Texas. Complete Schedule Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
Date
Payee name
Payee address; City; State; Zip Code
Category (See Categories listed at the top of this schedule) Description
Amount ($)
PURPOSE
OF
EXPENDITURE
❑ Check if travel outside of Texas. Complete Schedule n Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name Office sought Office held
expenditure to benefit C/OH
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
Forms provided by Texas Ethics Commission vwvw.ethics.state.tx.us Revised 11/13/2020